S-l-o-w starting shifts: what can I do to speed it up?

Nurses General Nursing

Published

We have an ongoing problem with people dragging their feet to start or end their shifts. I come in early to see where I'm going, then there are no Kardexes, then the offgoing people are nowhere to be found (we're supposed to give report outside the patients' rooms), then when you do find them they are busy with giving meds or whatever. When my shift ends and oncoming shift appears they will be doing 12 hour nights, and they are in no hurry to get started, to put it mildly. They want to chat with each other and fine tune their assignments, look up all their meds and labs, etc. before they want to take report. I waste about an hour of each shift with this sort of nonsense. When I try to get the wheels turning it's met with hostility and I'm subtly or not so subtly made to feel as though I must think I'm too good to socialize. I'm not too good to; I would be glad to socialize once I've picked up my patients or given them up on time. Any ideas?

nursej22, MSN, RN

3,770 Posts

Specializes in Public Health, TB.

Wow, this can be tough if this slow start is a part of the unit culture and is tolerated or at least not discouraged by your manager. If this is the case, change may have to come from the top.

Make sure you make "I" statements and not use terms like "nonsense" when referring to your coworkers. "I am ready to get started, I find my shift goes smoother when I can study the Kardex, what can I finish for you so that you can leave on time?" You might also make a comment about how well they get along or how nice it is to work with people who are also your friends, acknowledging the value they place on work relationships.

As for the oncoming shift, I would point out that you will be on OT past the half hour, and will be leaving on time unless they get your OT approved. And then do it.

Can you enlist the help of others on your shift? If you show a united front, you may be able to encourage change.

florianslove

75 Posts

Specializes in Home Health, SNF.

I totally understand where you're coming from. I used to do a 7-3 shift on a wing in a LTC. I would always be there by 6:45 A.M. so I could read the communication book, then wait (patiently, then increasingly inpatiently) for the floor nurse to get finished so I can get report and start passing my meds. It got to a point where she wasn't getting done until 7:30, 7:45, which put me way behind. I started coming in and trying to help her by doing accu checks, inhaler treatments etc., Our DON finally noticed and told her she must be off the unit and clocked out by 8:30 A.M., done with charting and everything. If she wasn't finished she could stay, but would not get paid past 8:30 A.M. Amazingly, she got a lot faster after that.

It really used to stress me out and be a bad start to my shift when I couldn't start on time. I hope your situation improves. I feel for you:heartbeat:heartbeat

zuzi

502 Posts

Specializes in trauma, ortho, burns, plastic surgery.

Is easy ... ask them to have a writing report prepared for you at the time when you are there... and you on the same time let a writing report for them at the time when it supposed to give the report. Much more you have a proof about what you let them know and what they let you know....easy...

UM Review RN, ASN, RN

1 Article; 5,163 Posts

Specializes in Utilization Management.

I'd start looking at the charts and checking labs and MARs when I came in. It gave me a chance to make sure all the meds were given / signed off, as well as giving me a quick head's up on which patients needed to take priority due to problemmatic labs.

Lots of time was saved by finding the problems that day shift might've missed that way.

anonymurse

979 Posts

I've always felt it's my job to acculturate, not the culture's job to change to fit me. That aside, if you seek change, you have to first meet the situation where it is and totally be there before you can nudge it elsewhere. This has nothing to do with what you feel is right. It's just a matter of what works.

t2krookie

82 Posts

Specializes in a lil here a lil there.

I completely understand and sympathize. I left a well paying position for this very reason. I joined a floor where the majority of the nurses had been on that particular unit for 10 years plus. They all new each other to one degree or another and did in fact spend an inordinate amount of time passing the torch to the oncoming shift.

The thing some people forget is that nursing is a 24hour 7 day a week job. When I come , I don't expect every order written 20 minutes ago to be done if you have put effort into getting done what you can when you could, likewise you best not expect me to have the 2 pages of orders written by the damn intern while I was doing patient care in the room right before your arrival to relieve me. This concept is called "teamwork". Utilizing teamwork , our patients receive top notch care, all of us have more reasonable expectations in our work environment, and we get to spend our OFF time with our families who need us.

If its just socializing , do it on YOUR time not mine. You slow me down and inhibit my ability to take care of our patients. If your trying to hand me a patient load on a silver platter, STOP! Just hand me the reins and I'll ride this hoarse untill tonight and you can have her back. If you or I have a problem with each others efforts, we can sit down for a minute and hash it out. If your having problems with time management , make a plan and implement it. If your slacking , pick up the pace and put down the coffee. If I'm not doing the same, call me on it. I might be slacking myself and just not realize it.

If this sounds harsh , I'm sorry but after 18 years , I don't ahve time to BS. I love doing my job, I love working with patients. The only thing that really gets me down is drama and laziness. Two things I definately dislike about nursing.

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